Who Is At Risk For Patent Foramen Ovale & Is There A Blood Test For It?

Studies have demonstrated that PFO has a strong association with thromboembolic events in young patients.1

Patients who have suffered a recurrent stroke and over the age of 55 have a high risk of patent foramen ovale.2

Patent foramen ovaleis often diagnosed through a color flow Doppler echocardiogram that detects the flow of blood between the right atrium and left atrium.3

Who Is At Risk For Patent Foramen Ovale?

It is still disputable whether certain characteristics of patent foramen ovaleare associated withan increased risk of developing stroke or is incidental. A study was conducted on 895 patients divided into two groups (Group 1: 493, Group 2: 402) to determine the morphometric features of patent foramen ovaleusing a meta-analytical approach. The study compared several PFO characteristics diagnosed through echocardiography in patients who experienced recurrent cryptogenic strokes and cerebrovascular accidents.1

The results showed the risk of cerebrovascular incidence was higher in patients who had the following

  • Large left to right shunt patent foramen ovale
  • Patients with a cardiac abnormality of uncertain clinical significance, a condition called a septal aneurysm

The echocardiography has been one of the most successful diagnostic methods to identify any clinical variation associated with a PFO. Furthermore, patients with conditions such as severe migraines, stroke, a transient ischemic attack also have an increased risk for patent foramen ovale

Severe Migraines– People with migraine headaches especially migraine with aura is more like to suffer an ischemic attack. A study shows that migraine with aura patients have three times higher chances for PFO and develop a clot in the heart. When the clot travels or dislodges in the brain, it results in a stroke.2

Is There A Blood Test ForPatent Foramen Ovale?

Diagnosing patent foramen ovaleisn’t easy unless an individual suffers symptoms like a severe migraine. To detect a PFO, the cardiologists used specialized diagnostic procedures that include

Bubble Study- This is a non-invasive test to determine a better view of the flow of the blood through the walls of the atrium. They are generally used in conjunction with echocardiography or a transcranial Doppler study. It involves filling an intravenous line in a vein in your arm, an injection of saline after agitation with air to create micro-bubbles.

Echocardiogram– It is a painless and safe procedure that uses high-frequency sound waves (ultrasound) to create a moving picture of the heart. Your doctor will determine how well your heart is working through the images produced by ultrasound.

Transesophageal Echo (TEE)- This is a specialized form of echocardiogram providing inside images of the heart rather than outside of your body. It uses a thin long tube called an endoscope inserted into the esophagus to assess the heart’s functionality.3

There are no specific blood tests to help diagnose the condition however the above-mentioned diagnostic tests are effective in identifying patent foramen ovale.

The American Heart Association explains patent foramen ovale (PFO) is not a serious condition unless it develops symptoms like severe migraines, transient ischemic stroke, or heart attacks. A study shows that more than 25 percent of the cases don’t even realize their condition until they suffer a stroke.

PFO itself does not produce symptoms so most people will not need treatment. But sometimes there are complications and stroke is one of the most serious. Patent foramen ovale often play a role in migraine headaches and enhances the risk of cardiovascular diseases (recurrent strokes)

References:

  1. Nakayama R;TakayaY;AkagiT;WatanabeN;IkedaM;NakagawaK;TohN;Ito H; “Identification of High-Risk Patent Foramen Ovale Associated With Cryptogenic Stroke: Development of a Scoring System.” Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/31130417/.
  2. Pinto, F J. “When and How to Diagnose Patent Foramen Ovale.” Heart (British Cardiac Society), Copyright 2005 by Heart, Apr. 2005, www.ncbi.nlm.nih.gov/pmc/articles/PMC1768819/.
  3. Publishing, Harvard Health. “What Is a Bubble Study?” Harvard Health, www.health.harvard.edu/heart-health/what-is-a-bubble-study.

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